ALEJANDRO ANTONIO TAVIRA CG 60475423 NPI 1588136048

NPI Information

NPI: 1588136048
Provider Name: ALEJANDRO ANTONIO TAVIRA, CG 60475423
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
7610 40TH ST W STE 300
UNIVERSITY PLACE, WA
ZIP 98466
Phone: (253) 830-6242
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Alejandro Antonio Tavira, CG 60475423 is a peer specialist in University Place, WA. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Alejandro Antonio Tavira, CG 60475423 NPI is 1588136048. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

7610 40TH ST W STE 300
UNIVERSITY PLACE, WA
ZIP 98466-834
Phone: (253) 830-6242

The enumeration date for this NPI number is 12/21/2018 and was last updated on 9/5/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	CG60475423	WASHINGTON	No
2	175T00000X	Peer Specialist				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CG60475423	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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